May 13, 2004J.Petrie-Thomas PARENT-INFANT INTERACTION: Biobehavioral Regulation, Theory, Research &...

May 13, 2004 J.Petrie-Thomas

PARENT-INFANT INTERACTION:PARENT-INFANT INTERACTION: Biobehavioral Regulation, Theory, Biobehavioral Regulation, Theory,

Research & AssessmentResearch & Assessment

Julie Petrie-Thomas, PhD Candidate, IISGP, UBC, Centre for Community Child Health Research, BC Research Institute for Children’s & Women’s Health.

David Hayley, Ph.D. Post-Doctoral Fellow, Dept. of Pediatrics, UBC, & Centre for Community Child Health Research, BC Research Institute for Children’s & Women’s Health.


1. Historical overview of some of the major theoretical contributors

2. Parent-infant interaction

3. Biobehavioral research and Parent-infant interaction

Infant regulation of behavior and physiology:• Attention• Stress• Heart Rate (HR)• Cortisol

How the Parent-Infant Relationship Influences Development


• Man as a biological organism governed by drives

• Reduced tension through the agency of an object

• Regulatory role played by the object or person that served the infant’s instincts which was most often mother

• In listening to an individual, one was in effect witnessing an internal relationship

Freud with mother Amalia

Psychoanalytic Perspective: Consistently Emphasized the Importance of Relationship


Developmental Perspective

• Extended theory of drive satisfaction to include the role of the parent in structuring the child’s mind

• Identified stages of development beginning with biological unity between mother-infant dyad

• Psychological disorder examined within the process of developmental evolution, by coming to terms with conflicts as determining the risk of pathology

Freud with Daughter Anna 1912


Mary Ainsworth (1913-1999): Notion of mother as “Secure Base”

John Bowlby (1907-1990): Term “Interaction” in “The Nature of the Child’s Tie to His Mother”, 1958).

Anna Freud (1895-1992) & Melanie Klein (1882-1960)– Psychoanalytic Theory M. Mahler: 1st to Study Observable Interactions - “Holding Environment” – Mother As Organizer & Regulator (Infant homeostatis), “Physiological” to “Social Symbiosis”

D. Winnicott (1896-1971): Importance of Sensitivity, Mirroring “Goodenough Mothering” and Father As Primary Caretaker, Parent-infant “Affective Communication Systems”

Further Inquiry & Theory: Parent-Infant Relationship


Anna Freud & Renee Spitz Maternal Deprivation (1940’s)

• Children deprived of maternal relationship during war or in institutions such as hospitals or foundling homes

• Spitz’s classic studies “hospitalization syndrome”

• Observed effects of “marasmus” (wasting away for no physiological cause or “anaclytic depression” (reaction to separation from mother)

• Anna Freud’s observations of children during WWII “cast a shaft of light on the nature of many forms of psychiatric disturbance” (Bowlby, 1973)

• Provided dramatic insight into critical nature of earliest relationship


Joseph Sandler 1927-1998

(Student of Anna Freud)

• Introduced concept of background of safety (1959)– Ego able to maximize security rather than to avoid anxiety

• Revolutionary thinking re: infant’s representational world– Relationships viewed as “a set of expectations relating to the

mother’s appearance and activities”– Relationships had “shape”, added critical emotional tone to

organizing interpersonal experience– Conscious thinking as embedded within a matrix of feeling states that

give rise to all adaptation

• This set precedent for affect as a basis of infant’s interactions widely acknowledged by many today – E.g. Dante Cicchetti, Robert Emde, Alan Sroufe


Harlow’s Studies with Rhesus Monkeys – Early 1950’s

•Socially isolated newborn monkeys (birth to 1 yr) were severely socially impaired - such vulnerability was not detected when older animals were isolated

•Mother-infant tie was built around warmth, protection and security rather than an oral object (Bowlby, 1969)


Effects of Separation: Maternal Deprivation

• Renee Spitz (1945) - In many institutions, despite the best of medical care, 50% of infants died if they had established a good relationship with the mother and then were separated prior to 2 yrs

• Anna Freud (1953) - Providing 1 constant mother figure for each group of infants, instead of a rotation of nurses, eliminated many of the infant deaths

• Harlow (1958,1979) – Monkeys reared by a terry cloth mother would not mate -one that did batted her infant away when it came to feed


Balanced by: Ethological Studies

• Konrad Lorenz’s work on imprinting (1957)

• Led to recognition of infant’s role in “releasing” maternal responses (e.g. by cry)

• View of infant as more active participant


Ethological Studies: Contributions

• Identification of “critical periods” – predict developmental trajectories

• Naturalistic and detailed analysis - Micro-analytic techniques and timing

• Mother/Infant as part of community – social structure can be derived from the variety of interactions between it’s members

• Robert Hinde – descriptions of interactions to include not only what but how partners interact (quality of interaction)


John Bowlby (1907-1990)

• Integrated biological concepts and psychoanalytic theory

• Viewpoint that early development may set the course for later development (Bowlby, 1973)

• Emphasized the importance of reciprocal regulatory control systems that are open to influence by the environment in which development occurs (dyadic system)

• Idea that infant attachment behaviors are used to maintain proximity of the primary caregiver (Bowlby, 1958; Bowlby, 1969)

• This gave rise to the concept of attachment as a construct that described the mother-infant relationship


Mary Ainsworth (1913-1999)

• Colleague of Bowlby • Also influenced by Harlow’s work• Defined maternal deprivation as

lack of interaction• Attachment occurs as a result of

child’s activity, rather than through the passive need gratification or external stimulation

• Interaction as dyadic - initiated by either member of the pair


Mary Ainsworth: Canada, UK, Uganda, USA

“Petero felt much more secure after his mother picked him up."

•Established notion of mother as “secure base”

•Introduced notion that exploration occurs if infant feels secure

•Quality of attachment highly dependant on maternal sensitivity to infant cues


Animal Studies: Infant Rat Pups• Maternal regulation of multiple infant systems after

birth – mother as hidden “regulator” • Concept of state organization bridged gap between

structure and function, and ultimately between biology and psychology

•Myron A. Hofer, M.D.


Barry Brazelton Motivation model of competence inspired work in the area of neonatal assessment – i.e. organisms capacity to interact effectively with environment

(accounting for exploratory behavior, manipulation and general activity)

•View of infant as competent and active participant provided support for early social engagements as central to development – and form basis of parent infant interaction theory

•Viewed the infant’s achievement of homeostatic control and drive to reach out for and incorporate cues from the environment as a biomodal fueling system for energizing development

•Differences in state regulation as reflecting neurological integrity and providing an opportunity for diagnosis, prediction and for communicating with and influencing the parent-infant systems for “at-risk” infants


Developmental Systems View

• Coined term " Good enough mother“

• Theorized that there is never just an infant, but an infant-mother pair

• Babies gain knowledge about objects from their experiences with the mother

• If young children are deprived of a nurturing environment, such as in the case of an alcoholic or abusive parent, infants learn that objects come and go unpredictably

D.W. Winnicott, British psychiatrist (1896-1971)


Louis Sander Influenced by: Erikson & Spitz

• Erikson (development/interactions with environment)

• Spitz (developmental imbalance resulting from asynchrony of maturational periods of development and object relations)

• Recognized that parent-infant interaction varies dramatically as a result of developmental change


Sander’s 5 Qualitatively Distinct PeriodsSander’s 5 Qualitatively Distinct Periods and Developmental Interactive Context

• 0 to 2½ months: “Initial Adaptation”Feeding, putting to sleep, parent sensitivity to cue,

ability to read infant cues, infant response to soothing

• 2½ to 5 months: “Reciprocal Exchange” Face-to-face interaction: maintenance or

termination, modulation, termination or avoidance of face-face engagement


Developmental Periods &Developmental Periods & Contexts (cont’)Contexts (cont’)

• 5 to 9 months “Early Directed Activity” Joint object play, how dyad directs play, timing, attention/focus,

elaboration, scaffolding, involvement, organization, intrusiveness or synchrony of parent-infant relationship

• 9 to12 months “Focalization on the Parent”Attachment

• 12 to18 months “Establishment of Early Autonomy” Control issues, increased mobility, limit setting


Family Context and Child Development

• Ecological systems theories • Transactional theories of development• Family systems theories

• ALL emphasize the embeddedness of children in family systems and the family’s importance in development (Bowen, 1978; Brofenbrenner, 1979; Sameroff, 1975; Steinberg & Avenevoli, 2000).


Concepts & Terminology: Dyadic Interaction

• Spitz “Mother-Infant Dialogue”

• Bateson (1971) “Protoconversations”

• Stern – critical importance of timing, rhythm, structure for the infant to form temporal expectancies, organize attachment, social, self-regulation of affect and state

• Trevarthen (1979) “Conversational Negotiation of Emotions”

• Papousek & Papousek (late 70’s) rhythmic approach to gaze, vocalization and facial interactions as central to bonding “Intuitive Parenting”


Dyadic InteractionDyadic Interaction

• Affect regulation as the basis of “Mutual Regulation” (Tronick et al.,1986) “Entrainment” or “Attunement” (e.g. Field, 1994)

• Dyadic coordinations = “Co-occurrence”, “Matching”, “Reciprocity”, “Coherence”

• Tiffany Field (e.g.1981) emphasized integration of infant arousal, attention and affect as components of early interactions, gaze aversion and changes in HR prior to affect changes


Neurobiology Perspective• “Neural sculpting” - social and physical environments organize the

experiences that shape the networks and patterns of the brain (e.g. Cynader et. al., 1999)

• Hofer (1990), Schore (1994) & Trevarthern (1990) have emphasized the 2-way connection between brain maturation and social-emotional development

• Changes in brain circuitry are dependent on the the socio-affective context (Sroufe, 1996)

• Experience with caretakers interacts with genetic/constitutional factors to produce neural networks that function to regulate affect (Schore)– Communications are fast acting or “hidden” -mother senses and

modulates the non-verbal and affective expressions of the infant’s psychobiological state

– These neural networks provide the basis for automatic patterning of activity


Prematurity : High Variability of Prematurity : High Variability of OutcomesOutcomes

• Heterogeneity of Heterogeneity of outcomesoutcomes

• Suggests a complex interplay of biological vulnerability and psycho-social influence


Effects of Maternal Behavior on Preterm Effects of Maternal Behavior on Preterm PhysiologyPhysiology

• One premature study has examined the effects of maternal behavior on infant behavior and physiology (Zeskind, O'Grady, & Tremblay, 2001)

• Early psychosocial interventions for mothers improved neonatal autonomic regulation (flexibility of behavioural state & temporal organization of heart rate)

• Conducted in the neonatal period (NICU)

Aim of Novel Study Parent-Infant interactions influence on:

- Behavioural attention - HR response


Preterm Research:Preterm Research:Consistent ResponsivenessConsistent Responsiveness

Maternal responsiveness during infancy and early adolescence:

– Faster cognitive growth and higher IQ – Higher arithmetic scores – More positive self-esteem– Teachers reported fewer behavioral and

emotional problems


Preterms More Strongly Influenced by Preterms More Strongly Influenced by Their EnvironmentsTheir Environments

• Contextual factors accounted for 40% to 60% of the variance in outcome at 2 years compared to 15-30% for the full-terms

• Quality of parent-infant interaction mediates the relation between neonatal risk status and later cognition


Parent-Preterm Interaction• Infants of more responsive

parents are able to tap into a greater source of external regulation (Weinberg, Tronick, Cohn, & Olson, 1999).

• Parenting supports nervous system function, regulation and neural feedback systems, which take place within dyadic interaction (Porges, 2002).

• Preterm infant’s neuro-regulatory capacity is not developed, thus the caregiver provides this capacity (Porges, 2002).


Physiological & Behavioral Physiological & Behavioral RegulationRegulation

• Regulation of HR plays a crucial role in infant’s modulation of affect and social behaviour (Bazhenova, Plonskaia, & Porges, 2001).

• Recovery of HR rate to challenge linked to higher parent responsiveness (Haley & Stansbury, 2003).


Parent –Infant Interactions & Cardiac Parent –Infant Interactions & Cardiac Autonomic Regulation (5-6 months)Autonomic Regulation (5-6 months)

• Positive link between synchronous patterns of parent-infant interactions and the infants’ physiological regulatory abilities (i.e. greater heart rate variability, parasympathetic regulation) (Porter, 2003)


Research Measures: Dyadic Research Measures: Dyadic InteractionInteraction

• Developmentally appropriate?

• Established using specific/special populations?

• Reliability and validity?

• Appropriate for setting?

• Constructs address research/clinical questions?


Global Mother-infant Interaction Ratings: Global Mother-infant Interaction Ratings: 8 &18 Months & 3 Years 8 &18 Months & 3 Years

Crnic et al (1983).


Mother and Infant ratingsMother and Infant ratings• Mothers & Infants rated

according to their:

1) Gratification from interaction

2) General affective tone (angry, irritated to happy, positive)

3) Mother sensitivity (intrusiveness to synchrony) and Infant Responsiveness (avoidant to active involvement)

Crnic et al (1983).


Mother-preterm Interaction at 8-monthsMother-preterm Interaction at 8-months

• No differences in mother behaviors across groups (Mother Sensitivity, Gratification and Affect)

• Behavioral differences: Infant Responsiveness and Infant Affect for the high-risk premature group only

Grp 1: High-risk (< 29 weeks; N=29)

Grp 2: Lower-risk (30-32 weeks, N=26)

Grp 3: Term-borns (N=36)

•Mother Affect - highly correlated with all infant behaviors (Responsiveness, Affect and Gratification) for the highest risk preterm group only (r=.48, .53, .69)

Petrie-Thomas & Grunau, CCCHR, 2004


Findings Related to Development?Findings Related to Development?

• 2½ to 5 months: “Reciprocal Exchange” Face-to-face interaction: maintenance or

termination, modulation, avoidance of engagement

• 5 to 9 months “Early Directed Activity” Joint object play, how dyad directs play, timing,

attention/focus, elaboration, scaffolding, involvement, organization, intrusiveness or synchrony of relationship

May 13, 2004J.Petrie-Thomas PARENT-INFANT INTERACTION: Biobehavioral Regulation, Theory, Research &...

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